PMID- 26967126
OWN - NLM
STAT- MEDLINE
DCOM- 20170130
LR  - 20181202
IS  - 1744-764X (Electronic)
IS  - 1474-0338 (Linking)
VI  - 15
IP  - 5
DP  - 2016 May
TI  - Safety and tolerability of antipsychotic co-treatment in patients with 
      schizophrenia: results from a systematic review and meta-analysis of randomized 
      controlled trials.
PG  - 591-612
LID - 10.1517/14740338.2016.1165668 [doi]
AB  - INTRODUCTION: Antipsychotic co-treatment is common in schizophrenia, despite 
      lacking evidence for its efficacy and safety. Areas: We conducted a systematic 
      search of PubMed/PsycInfo/CJN/WangFan/CBM without language restrictions from 
      database inception until 05/25/2015 for randomized trials comparing antipsychotic 
      monotherapy with antipsychotic co-treatment in >/=20 adults with schizophrenia 
      reporting meta-analyzable adverse events (AEs) data. Meta-analyzing 67 studies 
      (n=4,861, duration=10.3+/-5.2 weeks), antipsychotic co-treatment was similar to 
      monotherapy regarding intolerability-related discontinuation (risk ratio 
      (RR)=0.84, 95% confidence interval (CI)=0.53-1.33, p=0.455). While incidence of 
      >/=1 AE was lower with antipsychotic co-treatment (RR=0.77, 95%CI=0.66-0.90, 
      p=0.001), these results were solely driven by open-label and efficacy-focused 
      studies. Adjunctive D2-antagonists lead to less nausea (RR=0.220, 
      95%CI=0.06-0.87, p=0.030) and insomnia (RR=0.26, 95%CI=0.08-0.86, p=0.028), but 
      higher prolactin (SMD=2.20, 95%CI=0.43-3.96, p=0.015). Conversely, adjunctive 
      partial D2-agonists (aripiprazole=100%) resulted in lower electrocardiogram 
      abnormalities (RR=0.43, 95%CI=0.25-0.73, p=0.002), constipation (RR=0.45, 
      95%CI=0.25-0.79, p=0.006), drooling/hypersalivation (RR=0.14, 95%CI=0.07-0.29, 
      p<0.001), prolactin (SMD=-1.77, 95%CI=-2.38, -1.15, p<0.001), total and 
      LDL-cholesterol (SMD=-0.33, 95%CI=-0.55, -0.11, p=0.003; SMD=-0.33, 95%CI=-0.54, 
      -0.10, p=0.004). EXPERT OPINION: No double-blind evidence for altered AE burden 
      associated with antipsychotic co-treatment was found. However, AEs were 
      insufficiently and incompletely reported and follow-up duration was modest. 
      Adjunctive partial D2-agonists might be beneficial for counteracting several AEs. 
      High-quality, long-term studies that comprehensively assess AEs are needed.
FAU - Galling, Britta
AU  - Galling B
AD  - a The Zucker Hillside Hospital , Psychiatry Research, Northwell Health , Glen 
      Oaks , NY , USA.
FAU - Roldan, Alexandra
AU  - Roldan A
AD  - b Department of Psychiatry, Institut d'Investigacio Biomedica-Sant Pau (IIB-SANT 
      PAU) , Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona 
      (UAB) , Barcelona , Spain.
FAU - Rietschel, Liz
AU  - Rietschel L
AD  - c University Hospital of Child and Adolescent Psychiatry and Psychotherapy , 
      University of Bern , Bern , Switzerland.
FAU - Hagi, Katsuhiko
AU  - Hagi K
AD  - a The Zucker Hillside Hospital , Psychiatry Research, Northwell Health , Glen 
      Oaks , NY , USA.
AD  - d Sumitomo Dainippon Pharma Co., Ltd., Medical Affairs , Tokyo , Japan.
FAU - Walyzada, Frozan
AU  - Walyzada F
AD  - a The Zucker Hillside Hospital , Psychiatry Research, Northwell Health , Glen 
      Oaks , NY , USA.
FAU - Zheng, Wei
AU  - Zheng W
AD  - e Department of Psychiatry, Guangzhou Brain Hospital (Guangzhou Huiai Hospital), 
      Affilated Hospital of Guangzhou Medical University , Guangzhou , China.
FAU - Cao, Xiao-Lan
AU  - Cao XL
AD  - f Department of Psychiatry , Chinese University of Hong Kong , Hong Kong , China.
FAU - Xiang, Yu-Tao
AU  - Xiang YT
AD  - g Unit of Psychiatry, Faculty of Health Sciences , University of Macau , Macao , 
      China.
FAU - Kane, John M
AU  - Kane JM
AD  - a The Zucker Hillside Hospital , Psychiatry Research, Northwell Health , Glen 
      Oaks , NY , USA.
AD  - h Hofstra North Shore LIJ School of Medicine , Hempstead , NY , USA.
AD  - i The Feinstein Institute for Medical Research , Manhasset , NY , USA.
AD  - j Albert Einstein College of Medicine , Bronx , NY , USA.
FAU - Correll, Christoph U
AU  - Correll CU
AD  - a The Zucker Hillside Hospital , Psychiatry Research, Northwell Health , Glen 
      Oaks , NY , USA.
AD  - h Hofstra North Shore LIJ School of Medicine , Hempstead , NY , USA.
AD  - i The Feinstein Institute for Medical Research , Manhasset , NY , USA.
AD  - j Albert Einstein College of Medicine , Bronx , NY , USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20160407
PL  - England
TA  - Expert Opin Drug Saf
JT  - Expert opinion on drug safety
JID - 101163027
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Dopamine D2 Receptor Antagonists)
RN  - 0 (Receptors, Dopamine D2)
SB  - IM
MH  - Adult
MH  - Antipsychotic Agents/*administration & dosage/adverse effects/pharmacology
MH  - Dopamine D2 Receptor Antagonists/administration & dosage/adverse effects
MH  - Drug Partial Agonism
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Randomized Controlled Trials as Topic
MH  - Receptors, Dopamine D2/*drug effects/metabolism
MH  - Schizophrenia/*drug therapy
OTO - NOTNLM
OT  - Antipsychotics
OT  - adverse effects
OT  - augmentation
OT  - combination
OT  - cotreatment
OT  - metaanalysis
OT  - monotherapy
OT  - polypharmacy
OT  - safety
OT  - schizophrenia
OT  - tolerability
EDAT- 2016/03/12 06:00
MHDA- 2017/01/31 06:00
CRDT- 2016/03/12 06:00
PHST- 2016/03/12 06:00 [entrez]
PHST- 2016/03/12 06:00 [pubmed]
PHST- 2017/01/31 06:00 [medline]
AID - 10.1517/14740338.2016.1165668 [doi]
PST - ppublish
SO  - Expert Opin Drug Saf. 2016 May;15(5):591-612. doi: 10.1517/14740338.2016.1165668. 
      Epub 2016 Apr 7.